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Balogun OO, K C Bhandari A, Tomo CK, Tchicondingosse L, Aoki A, Aiga H, Takehara K. Association of sociodemographic and maternal healthcare factors with birth registration in Angola. Public Health 2023; 223:94-101. [PMID: 37625273 DOI: 10.1016/j.puhe.2023.07.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 08/27/2023]
Abstract
OBJECTIVES Angola has a high burden of unregistered children and efforts to increase birth-registration coverage have not yielded the desired progress. This study aimed to examine sociodemographic and healthcare-related factors associated with birth registration in Angola. STUDY DESIGN Secondary data analysis of the Maternal and Child Health (MCH) Handbook randomised controlled trial conducted in Benguela province, Angola and involving 11,006 women. METHODS For this analysis, we excluded women with missing data on birth registration (n = 1424), multiple gestation (n = 243), and those with infant death (n = 6). The final study population included 9333 women with infants under one year of age. We used multilevel mixed-effects logistic regression analysis to determine sociodemographic and healthcare-related factors associated with the registration of a child's birth. RESULTS Of the 9333 live births, 25% (95% confidence interval [CI] = 13.4-41.8) were registered, while 21% (95%CI = 11.1-35.7) were registered with certificate. There were higher proportions of registered births among mothers who possessed the MCH Handbook across various demographic and healthcare indicators. Birth registration was most significantly associated with facility-based delivery (odds ratio [OR] = 2.97; 95%CI = 2.45-3.61), possession of MCH Handbook (OR = 2.04; 95%CI = 1.70-2.46), and complete scheduled vaccination visits (OR = 1.69; 95%CI = 1.44-1.97). Higher maternal age and education level, belonging to the highest wealth quintile, beginning antenatal care in the first trimester, attending at least four antenatal care visits, and using postnatal care services were positively associated with registration of birth. CONCLUSION Maternal healthcare factors showed significant associations with birth registration and integrating birth-registration processes with certain maternal and child health services may further raise awareness and boost registration levels in Angola.
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Affiliation(s)
- O O Balogun
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan.
| | - Aliza K C Bhandari
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan; Graduate School of Public Health, St Luke's International University, Tokyo Japan; Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - C K Tomo
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
| | | | - A Aoki
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
| | - Hirotsugu Aiga
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - K Takehara
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
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Maeda A, Tsuchida N, Uchiyama Y, Horita N, Kobayashi S, Kishimoto M, Kobayashi D, Matsumoto H, Asano T, Migita K, Kato A, Mori I, Morita H, Matsubara A, Marumo Y, Ito Y, Machiyama T, Shirai T, Ishii T, Kishibe M, Yoshida Y, Hirata S, Akao S, Higuchi A, Rokutanda R, Nagahata K, Takahashi H, Katsuo K, Ohtani T, Fujiwara H, Nagano H, Hosokawa T, Ito T, Haji Y, Yamaguchi H, Hagino N, Shimizu T, Koga T, Kawakami A, Kageyama G, Kobayashi H, Aoki A, Mizokami A, Takeuchi Y, Motohashi R, Hagiyama H, Itagane M, Teruya H, Kato T, Miyoshi Y, Kise T, Yokogawa N, Ishida T, Umeda N, Isogai S, Naniwa T, Yamabe T, Uchino K, Kanasugi J, Takami A, Kondo Y, Furuhashi K, Saito K, Ohno S, Kishimoto D, Yamamoto M, Fujita Y, Fujieda Y, Araki S, Tsushima H, Misawa K, Katagiri A, Kobayashi T, Hashimoto K, Sone T, Hidaka Y, Ida H, Nishikomori R, Doi H, Fujimaki K, Akasaka K, Amano M, Matsushima H, Kashino K, Ohnishi H, Miwa Y, Takahashi N, Takase-Minegishi K, Yoshimi R, Kirino Y, Nakajima H, Matsumoto N. Efficient detection of somatic UBA1 variants and clinical scoring system predicting patients with variants in VEXAS syndrome. Rheumatology (Oxford) 2023:kead425. [PMID: 37606963 DOI: 10.1093/rheumatology/kead425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 07/04/2023] [Accepted: 08/01/2023] [Indexed: 08/23/2023] Open
Abstract
OBJECTIVES To efficiently detect somatic UBA1 variants and establish a clinical scoring system predicting patients with pathogenic variants in VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome. METHODS Eighty-nine Japanese patients with clinically suspected VEXAS syndrome were recruited [81 males and 8 females; median onset age (IQR) 69.3 years (62.1-77.6)]. Peptide nucleic acid-clamping PCR (PNA-PCR), regular PCR targeting exon 3 clustering UBA1 variants, and subsequent Sanger sequencing were conducted for variant screening. Partitioning digital PCR (pdPCR) or targeted amplicon deep sequencing (TAS) was also performed to evaluate the variant allele frequency (VAF). We developed our clinical scoring system to predict UBA1 variant-positive and ‑negative patients and assessed the diagnostic value of our system using receiver operating characteristic (ROC) curve analysis. RESULTS Forty patients with reported pathogenic UBA1 variants (40/89, 44.9%) were identified, including a case having a variant with VAF of 1.7%, using a highly sensitive method. Our clinical scoring system considering >50 years of age, cutaneous lesions, lung involvement, chondritis, and macrocytic anaemia efficiently predicted patients with UBA1 variants (the area under the curve for the scoring total was 0.908). CONCLUSIONS Genetic screening with the combination of regular PCR and PNA-PCR detected somatic UBA1 variants with high sensitivity and specificity. Our scoring system could efficiently predict patients with UBA1 variants.
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Affiliation(s)
- Ayaka Maeda
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Naomi Tsuchida
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
- Department of Rare Disease Genomics, Yokohama City University Hospital, Yokohama, Japan
| | - Yuri Uchiyama
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
- Department of Rare Disease Genomics, Yokohama City University Hospital, Yokohama, Japan
| | - Nobuyuki Horita
- Chemotherapy Center, Yokohama City University Hospital, Yokohama, Japan
| | - Satoshi Kobayashi
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Tokyo, Japan
| | - Mitsumasa Kishimoto
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Tokyo, Japan
| | - Daisuke Kobayashi
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Haruki Matsumoto
- Department of Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tomoyuki Asano
- Department of Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kiyoshi Migita
- Department of Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Ayaka Kato
- Department of General Internal Medicine, Gifu University Hospital, Gifu, Japan
| | - Ichiro Mori
- Department of General Internal Medicine, Gifu University Hospital, Gifu, Japan
| | - Hiroyuki Morita
- Department of General Internal Medicine, Gifu University Hospital, Gifu, Japan
| | - Akihiro Matsubara
- Department of Dermatology, Chita Kosei Hospital, Mihama, Aichi, Japan
| | - Yoshiaki Marumo
- Department of Hematology and Oncology, Graduated school of medicine, Nagoya City University, Nagoya, Aichi, Japan
| | - Yuji Ito
- Department of General Internal Medicine, Chutoen General Medical Center, Kakegawa, Shizuoka, Japan
| | - Tomoaki Machiyama
- Department of Rheumatology, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Tsuyoshi Shirai
- Department of Rheumatology, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Tomonori Ishii
- Department of Rheumatology, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Mari Kishibe
- Department of Dermatology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Yusuke Yoshida
- Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital, Hiroshima, Japan
| | - Shintaro Hirata
- Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital, Hiroshima, Japan
| | - Satoshi Akao
- Division of Rheumatology, Department of Internal Medicine, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Akitsu Higuchi
- Division of Rheumatology, Department of Internal Medicine, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Ryo Rokutanda
- Division of Rheumatology, Department of Internal Medicine, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Ken Nagahata
- Department of Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Hiroki Takahashi
- Department of Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Koske Katsuo
- Department of Dermatology, Kurashiki Central Hospital, Kurashiki, Okayama, Japan
| | - Toshio Ohtani
- Department of Dermatology, Kurashiki Central Hospital, Kurashiki, Okayama, Japan
| | - Hiroshi Fujiwara
- Division of Rheumatology and Allergy, Osaka General Medical Center, Osaka, Japan
| | - Hiromichi Nagano
- Division of Rheumatology and Allergy, Osaka General Medical Center, Osaka, Japan
| | - Takashi Hosokawa
- Division of Rheumatology and Allergy, Osaka General Medical Center, Osaka, Japan
| | - Takanori Ito
- Department of Rheumatology, Daido Hospital, Nagoya, Aichi, Japan
| | - Yoichiro Haji
- Department of Rheumatology, Daido Hospital, Nagoya, Aichi, Japan
| | - Hiroyuki Yamaguchi
- Department of Rheumatology, Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan
| | - Noboru Hagino
- Department of Rheumatology, Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan
| | - Toshimasa Shimizu
- Departments of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tomohiro Koga
- Departments of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Atsushi Kawakami
- Departments of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Goichi Kageyama
- Department of Rheumatology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Hyogo, Japan
| | - Hiroshi Kobayashi
- Department of Rheumatology, Tokyo Medical University Hachioji Medical Center, Hachioji, Tokyo, Japan
| | - Akiko Aoki
- Department of Rheumatology, Tokyo Medical University Hachioji Medical Center, Hachioji, Tokyo, Japan
| | - Akinari Mizokami
- Department of Rheumatology, Japan Community Healthcare Organization (JCHO), Isahaya General Hospital, Isahaya, Nagasaki, Japan
| | - Yoichi Takeuchi
- Department of Rheumatology and Nephrology, Japanese Red Cross Maebashi Hospital, Maebashi, Gunma, Japan
| | - Rena Motohashi
- Department of Rheumatology and Nephrology, Japanese Red Cross Maebashi Hospital, Maebashi, Gunma, Japan
| | - Hiroyuki Hagiyama
- Department of Rheumatology, Yokohama City Minato Red Cross Hospital, Yokohama, Kanagawa, Japan
| | - Masaki Itagane
- Department of Rheumatology, Okinawa Chubu Hospital, Uruma, Okinawa, Japan
| | - Hiroyuki Teruya
- Department of Allergy and Rheumatology, Graduation School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Tomohiro Kato
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, Fuchu, Tokyo, Japan
| | - Yuji Miyoshi
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, Fuchu, Tokyo, Japan
| | - Takayasu Kise
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, Fuchu, Tokyo, Japan
| | - Naoto Yokogawa
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, Fuchu, Tokyo, Japan
| | - Takako Ishida
- Department of Dermatology, Hiroshima General Hospital, Hatsukaichi, Hiroshima, JA, Japan
| | - Naoki Umeda
- Department of Dermatology, Hiroshima General Hospital, Hatsukaichi, Hiroshima, JA, Japan
| | - Shuntaro Isogai
- Division of Rheumatology, Department of Internal Medicine, Nagoya City University Hospital, Nagoya, Aichi, Japan
| | - Taio Naniwa
- Division of Rheumatology, Department of Internal Medicine, Nagoya City University Hospital, Nagoya, Aichi, Japan
| | - Toru Yamabe
- Division of Rheumatology, Department of Internal Medicine, Nagoya City University Hospital, Nagoya, Aichi, Japan
| | - Kaori Uchino
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute, Aichi, Japan
| | - Jo Kanasugi
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute, Aichi, Japan
| | - Akiyoshi Takami
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute, Aichi, Japan
| | - Yasushi Kondo
- Division of Rheumatology, Department of Internal medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Kazunori Furuhashi
- Division of Rheumatology, Department of Internal medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Koichi Saito
- Division of Rheumatology, Department of Internal medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Shigeru Ohno
- Center for Rheumatic Diseases, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Daiga Kishimoto
- Center for Rheumatic Diseases, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Mari Yamamoto
- Department of Rheumatology, Chubu Rosai Hospital, Nagoya, Aichi, Japan
| | - Yoshiro Fujita
- Department of Rheumatology, Chubu Rosai Hospital, Nagoya, Aichi, Japan
| | - Yuichiro Fujieda
- Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Sachiko Araki
- Department of Internal Medicine, Niizashiki Central General Hospital, Niiza, Saitama, Japan
| | - Hiroshi Tsushima
- Department of Internal Medicine and Rheumatology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan
| | - Kyohei Misawa
- Department of Hematology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan
| | - Akira Katagiri
- Department of Internal Medicine and Rheumatology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan
| | - Takahiro Kobayashi
- Department of General Medicine, National Defense Medical College Hospital, Tokorozawa, Saitama, Japan
| | - Kenichi Hashimoto
- Department of General Medicine, National Defense Medical College Hospital, Tokorozawa, Saitama, Japan
| | - Takehiro Sone
- Division of Hematology, Department of Internal Medicine, National Defense Medical College Hospital, Tokorozawa, Saitama, Japan
| | - Yukiko Hidaka
- Division of Respirology, Neurology and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Hiroaki Ida
- Division of Respirology, Neurology and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Ryuta Nishikomori
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Hiroshi Doi
- Department of Immunology, Shiga General Hospital, Moriyama, Shiga, Japan
| | | | - Keiichi Akasaka
- Department of Respiratory Medicine, Saitama Red Cross Hospital, Saitama, Japan
| | - Masako Amano
- Department of Respiratory Medicine, Saitama Red Cross Hospital, Saitama, Japan
| | - Hidekazu Matsushima
- Department of Respiratory Medicine, Saitama Red Cross Hospital, Saitama, Japan
| | - Kaori Kashino
- Department of Dermatology, Onomichi Municipal Hospital, Onomichi, Hiroshima, Japan
| | - Hidenori Ohnishi
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Yuki Miwa
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Noriyuki Takahashi
- Department of Education for Community-Oriented Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
- Department of General Medicine, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Kaoru Takase-Minegishi
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Ryusuke Yoshimi
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yohei Kirino
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hideaki Nakajima
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Naomichi Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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Uchino T, Okubo R, Takubo Y, Aoki A, Wada I, Hashimoto N, Ikezawa S, Nemoto T. Mediation Effects of Social Cognition on the Relationship between Neurocognition and Social Functioning in Major Depressive Disorder and Schizophrenia Spectrum Disorders. J Pers Med 2023; 13:jpm13040683. [PMID: 37109069 PMCID: PMC10142841 DOI: 10.3390/jpm13040683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/14/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND In schizophrenia spectrum disorders (SSD), social cognition mediates the relationship between neurocognition and social functioning. Although people with major depressive disorder (MDD) also exhibit cognitive impairments, which are often prolonged, little is known about the role of social cognition in MDD. METHODS Using data obtained through an internet survey, 210 patients with SSD or MDD were selected using propensity score matching based on their demographics and illness duration. Social cognition, neurocognition, and social functioning were evaluated using the Self-Assessment of Social Cognition Impairments, Perceived Deficits Questionnaire, and Social Functioning Scale, respectively. The mediation effects of social cognition on the relationship between neurocognition and social functioning were examined in each group. Invariances of the mediation model across the two groups were then analyzed. RESULTS The SSD and MDD groups had mean ages of 44.49 and 45.35 years, contained 42.0% and 42.8% women, and had mean illness durations of 10.76 and 10.45 years, respectively. In both groups, social cognition had significant mediation effects. Configural, measurement, and structural invariances across the groups were established. CONCLUSION The role of social cognition in patients with MDD was similar to that in SSD. Social cognition could be a common endophenotype for various psychiatric disorders.
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Affiliation(s)
- Takashi Uchino
- Department of Neuropsychiatry, Faculty of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan
- Department of Psychiatry and Implementation Science, Faculty of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Ryo Okubo
- Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8551, Japan
| | - Youji Takubo
- Department of Neuropsychiatry, Faculty of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Akiko Aoki
- Department of Neuropsychiatry, Faculty of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Izumi Wada
- Department of Neuropsychiatry, Faculty of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Naoki Hashimoto
- Department of Psychiatry, Graduate School of Medicine, Hokkaido University, North 15, West 7, Kita, Sapporo 060-8638, Japan
| | - Satoru Ikezawa
- Endowed Institute for Empowering Gifted Minds, Graduate School of Arts and Sciences, University of Tokyo, 3-8-1 Komaba, Meguro-ku, Tokyo 153-0041, Japan
| | - Takahiro Nemoto
- Department of Neuropsychiatry, Faculty of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan
- Department of Psychiatry and Implementation Science, Faculty of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan
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Yamashita M, Aoki A, Kobayashi H, Wakiya M, Nakatsugawa M. [A case of giant cell arteritis after prednisolone dose reduction during treatment of polymyalgia rheumatica]. Nihon Ronen Igakkai Zasshi 2023; 60:440-447. [PMID: 38171762 DOI: 10.3143/geriatrics.60.440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Giant cell arteritis (GCA) is closely associated with polymyalgia rheumatica (PMR). We herein report an 82-year-old woman who developed GCA during PMR treatment. She initially presented with shoulder pain and was diagnosed with PMR based on elevated serum C-reactive protein (CRP) levels and bursitis detected in both shoulders on ultrasonography (US). Treatment was initiated with a daily dose of 15 mg prednisolone (PSL), which led to rapid symptom alleviation, and the dosage was tapered to 1 mg/day. One month later, she developed myalgia extending from the lumbar region to the thigh and tenderness in the left temporal region. However, no abnormalities in the temporal artery were observed on US. Although the PSL dose was increased to 2 mg for relapse of PMR, the symptoms did not improve. One week later, she developed occipital pain with an increased CRP level of 9 mg/dL. She was diagnosed with GCA based on the 1990 ACR Classification Criteria. Fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) detected anomalous accumulations in the bilateral superficial temporal and vertebral arteries, but not in the larger vessels. We therefore diagnosed her with cranial-type GCA. At this time point, we repeated US and found a halo sign in the temporal artery. Although epithelioid and giant cells were not observed in the temporal artery biopsy, vascular inflammatory findings such as disruption of the internal elastic lamina and chronic inflammatory cell infiltration were noted. Symptoms improved immediately and CRP levels decreased after the PSL dose was increased to 30 mg daily. To mitigate the risk of steroid-induced diabetes, tocilizumab was introduced, and gradual tapering of PSL was implemented. In conclusion, we encountered a case of GCA that developed after PSL reduction during the course of PMR. PET/CT confirmed intracranial artery inflammation and facilitated a definitive diagnosis. Although PET/CT cannot be routinely performed for diagnose in Japan, we consider it useful as an adjunctive diagnostic tool.
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Affiliation(s)
- Mayu Yamashita
- Post-graduate Clinical Training Center, Tokyo Medical University Hachioji Medical Center
| | - Akiko Aoki
- Department of Rheumatology, Tokyo Medical University Hachioji Medical Center
| | - Hiroshi Kobayashi
- Department of Rheumatology, Tokyo Medical University Hachioji Medical Center
| | - Midori Wakiya
- Department of Pathology, Tokyo Medical University Hachioji Medical Center
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Uchino T, Okubo R, Takubo Y, Aoki A, Wada I, Hashimoto N, Ikezawa S, Nemoto T. Perceptions of and subjective difficulties with social cognition in schizophrenia from an internet survey: Knowledge, clinical experiences, and awareness of association with social functioning. Psychiatry Clin Neurosci 2022; 76:429-436. [PMID: 35768180 PMCID: PMC9543578 DOI: 10.1111/pcn.13435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 05/12/2022] [Accepted: 05/23/2022] [Indexed: 12/14/2022]
Abstract
AIM Social cognition impacts social functioning in schizophrenia; however, little is known about how patients with schizophrenia themselves perceive social cognition. This study, using an internet survey, aimed to investigate their knowledge of social cognition, clinical experiences related to social cognition, awareness of social cognition's role in one's social life, and the relationships between subjective difficulties with social cognition and social functioning. METHODS Data from 232 outpatients with schizophrenia (SZ) and 494 healthy controls (HC) were obtained through an internet survey and were weighted according to the demographics of the national population. A newly developed survey questionnaire on knowledge, experience, and awareness of social cognition was administered. Subjective difficulties were evaluated using the Self-Assessment of Social Cognition Impairments and the Observable Social Cognition Rating Scale. RESULTS Less than a quarter of both groups were familiar with the term or concept of social cognition. Less than 5% of both groups had experienced being assessed or treated for social cognition. More than half of both groups were aware of the relationship between social cognition and social functioning. The SZ group had higher levels of subjective difficulties than the HC group across all social cognitive domains. The attributional bias domain of subjective difficulties was negatively associated with social functioning. CONCLUSION Patients with schizophrenia had substantial subjective difficulties in social cognition, which they perceived as being related to social functioning. However, their knowledge of social cognition was limited, and the assessment and treatment might not be widespread in regular clinical practice.
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Affiliation(s)
- Takashi Uchino
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Tokyo, Japan
| | - Ryo Okubo
- Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Youji Takubo
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Tokyo, Japan
| | - Akiko Aoki
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Tokyo, Japan
| | - Izumi Wada
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Tokyo, Japan
| | - Naoki Hashimoto
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Satoru Ikezawa
- Endowed Institute for Empowering Gifted Minds, University of Tokyo Graduate School of Arts and Sciences, Tokyo, Japan
| | - Takahiro Nemoto
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Tokyo, Japan
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Hagiya H, Aoki A, Matsuo T, Ishikane M, Nakagawa H, Yoshioka T. The Illusionary Correlation in Antibiotic Prescriptions: It May Exist but Requires Further Elucidation With Rigorous Methodology. Clin Infect Dis 2022; 75:176. [PMID: 34864902 DOI: 10.1093/cid/ciab1011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Hideharu Hagiya
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Akiko Aoki
- Department of Rheumatology, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Takahiro Matsuo
- Department of Infectious Diseases, St. Luke's International Hospital, Tokyo, Japan
- Division of Infectious Diseases, Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Masahiro Ishikane
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroaki Nakagawa
- Department of General Internal Medicine, Fukushima Medical University, Fukushima, Japan
- Center for Innovative Research for Communities and Clinical Excellence, Fukushima Medical University, Fukushima, Japan
| | - Takashi Yoshioka
- Center for Innovative Research for Communities and Clinical Excellence, Fukushima Medical University, Fukushima, Japan
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Aoki A, Kobayashi H. AB0239 HOW SOLID MALIGNANCIES ARE DETECTED IN JAPANESE PATIENTS WITH RHEUMATOID ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundAccording to a meta-analysis reported in 20151), among solid malignancies (cancers), only lung cancer was at an increased risk in patients with rheumatoid arthritis (RA) compared with the general population. A Japanese cohort study reported that the incidence of cancers in patients with RA treated with biological DMARDs was not significantly elevated compared to the Japanese general population2). However, in recent years, malignancy has been one of the major causes of death in Japanese patients with RA3). It has been reported that there was an increased incidence of malignancies in patients treated with tofacitinib compared to TNF-alpha inhibitors. Clinicians need to pay more attention to emerging malignancies.ObjectivesWe explored how to detect cancer early in patients attending rheumatology outpatient clinics.MethodsIn this retrospective study, we studied 545 patients with RA who visited our rheumatology clinic between April 2011 and December 2021. Forty-five cases of cancer in 38 patients (31 women, 7 men) with RA were reviewed.ResultsCancer types: 9 breast, 8 lung, 6 colon, 5 uterus, 4 stomach, 2 prostate, 2 pancreas and 9 others. Five female patients had metachronous or simultaneous double cancers and one male patient had metachronous triple cancers. The median age at diagnosis of 45 cancers was 72 years old (IQR 63–76.5) and the median duration of RA prior to cancer diagnosis was 10 years (IQR 5–20.5).Lung: Seven cases were found by chest CT at the outpatient clinics; two at the start of bDMARDs and five during RA treatment.Stomach and Colon: Two cases of four stomach cancers were discovered due to the progression of anemia. Both patients were at an advanced stage with distant metastasis and died 2 months after diagnosis. On the other hand, four of six colon cancers were detected by the fecal occult blood test, and three were in remission.Of the 45 cases, only 8 cases were detected by cancer screening. In 15 cases, blood samples or imaging tests were the triggers cancer detection. Eight of the 15 cases were detected by routine examinations in the rheumatology outpatient clinic, but five cases were already in the advanced stage.Table 1.Forty-five cancers in 38 patients with rheumatoid arthritisSite of cancer nClue to cancer diagnosis and prognosis at the final visit (death - under treatment - remission)noticing symptomsVarious tests in outpatient clinic symptoms(-)Cancer ScreeningBreast98(1-4-3) 1(0-0-1)Lung81(1-0-0)7(2-3-2) Colon6 1(1-0-0)5(0-1-4)Stomach41(0-0-1)3(3-0-0) Cervix uteri31(0-0-1) 2(0-0-2)Corpus uteri22(0-2-0) Pancreas2 2(0-2-0) Prostate22(0-1-1) Skin*22(0-0-2) Oral/throat22(0-2-0) Duodenum11(0-0-1) Biliary tract11(0-1-0) Anus1 1(0-0-1)Bladder1 1(0-0-1) Brain1 1(0-1-0) Total4521(2-10-9)15(6-6-3)9(0-1-8)ConclusionWe have been performing cancer screening before RA treatment and performing routine blood, urine, and imaging tests to identify adverse effects. However, they cannot always find cancers at the early stage. Screening procedures for malignancy are strongly recommended4), but the consultation rates for breast and cervical cancer screening are lower in Japan than in European nations. We should encourage our patients to undergo usual age- and sex-appropriate cancer screening.References[1]Simon TA, et al. Incidence of malignancy in adult patients with rheumatoid arthritis: a meta-analysis. Arthritis Research and Therapy 2015; 17:212[2]Harigai M, et al. Risk for malignancy in rheumatoid arthritis patients treated with biological disease-modifying antirheumatic drugs compared to the general population: A nationwide cohort study in Japan. Modern Rheumatology 2016; 26:642[3]Nakajima A, et al. Mortality and cause of death in Japanese patients with rheumatoid arthritis based on a large observational cohort, IORRA. Scand J Rheumatol 2010; 39:360[4]Baillet A, et al. Points to consider for reporting, screening for and preventing selected comorbidities in chronic inflammatory rheumatic disease in daily practice: a EULAR initiative. Ann Rheum Dis 2016; 75:965Disclosure of InterestsNone declared
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Uchino T, Kotsuji Y, Kitano T, Shiozawa T, Iida S, Aoki A, Iwai M, Shirahata M, Seki A, Mizuno M, Tanaka K, Nemoto T. An integrated youth mental health service in a densely populated metropolitan area in Japan: Clinical case management bridges the gap between mental health and illness services. Early Interv Psychiatry 2022; 16:568-575. [PMID: 34743415 DOI: 10.1111/eip.13229] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/03/2021] [Accepted: 10/19/2021] [Indexed: 11/27/2022]
Abstract
AIMS A global movement, including in Asia, is seeking to establish integrated youth mental health services that provide early intervention in the continuum from mental health to mental illness. Clinical case management (CCM), in which a case manager becomes not only a coordinator of services but also a provider of psychosocial support, can establish a 'one-stop network' that supports youth in densely populated areas with various social resources. In 2019, we opened a community-based centre called 'SODA' in front of a metropolitan railway station, which was designed to be highly accessible, stigma-free and youth-friendly to provide CCM. We aimed to clarify its services and effectiveness of CCM. METHODS Data from 105 youths were investigated in a case-controlled study, dividing them into two groups: those who had received CCM for 6 months, and those whose needs were met in fewer sessions. RESULTS Twenty-one subjects who received CCM for 6 months had difficulties in more domains than the others. The mean of the total service minutes for the subjects who received CCM for 6 months was 491.3 min: psychological support (accounted for 24.8% of the time), support for community living (31.2%), work support (13.8%), family support (10.5%) and support for cooperation with other organizations (19.8%). Global Assessment of Functioning (GAF) score improved significantly, from 46.6 at baseline to 59.3 at 6 months. CONCLUSION Even in metropolitan areas with numerous medical facilities, young people can face high barriers to access. CCM can be effective as an early intervention for subjects developing mental illness.
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Affiliation(s)
- Takashi Uchino
- SODA, Youth Mental Health Council, Adachi, Japan.,Department of Neuropsychiatry, Toho University Faculty of Medicine, Ota, Japan.,Tokyo Adachi Hospital, Adachi, Japan
| | - Yumi Kotsuji
- SODA, Youth Mental Health Council, Adachi, Japan.,Tokyo Adachi Hospital, Adachi, Japan
| | - Tomoji Kitano
- SODA, Youth Mental Health Council, Adachi, Japan.,Department of Neuropsychiatry, Toho University Faculty of Medicine, Ota, Japan.,Tokyo Adachi Hospital, Adachi, Japan
| | - Takuma Shiozawa
- SODA, Youth Mental Health Council, Adachi, Japan.,Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Satomi Iida
- SODA, Youth Mental Health Council, Adachi, Japan.,Tokyo Adachi Hospital, Adachi, Japan
| | - Akiko Aoki
- SODA, Youth Mental Health Council, Adachi, Japan.,Department of Neuropsychiatry, Toho University Faculty of Medicine, Ota, Japan
| | - Momoko Iwai
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Ota, Japan
| | - Masanori Shirahata
- SODA, Youth Mental Health Council, Adachi, Japan.,Tokyo Adachi Hospital, Adachi, Japan
| | - Akihiko Seki
- SODA, Youth Mental Health Council, Adachi, Japan.,Tokyo Adachi Hospital, Adachi, Japan
| | - Masafumi Mizuno
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Ota, Japan.,Tokyo Metropolitan Matsuzawa Hospital, Setagaya, Japan
| | - Kuniaki Tanaka
- SODA, Youth Mental Health Council, Adachi, Japan.,Department of Neuropsychiatry, Toho University Faculty of Medicine, Ota, Japan.,Tokyo Adachi Hospital, Adachi, Japan
| | - Takahiro Nemoto
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Ota, Japan
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Aoki A, Yamane M, Aoyama Y. A rare case of reactive granulomatous dermatitis during COVID-19: a possible role of cephalosporine and potential mechanisms. J Eur Acad Dermatol Venereol 2022; 36:e609-e611. [PMID: 35352414 PMCID: PMC9114838 DOI: 10.1111/jdv.18119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/25/2022] [Indexed: 12/02/2022]
Affiliation(s)
- A Aoki
- Department of Dermatology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
| | - M Yamane
- Department of Dermatology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
| | - Y Aoyama
- Department of Dermatology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
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Yunaiyama D, Aoki A, Kobayashi H, Someya M, Okubo M, Saito K. Eustachian tube involvement in a patient with relapsing polychondritis detected by magnetic resonance imaging: A case report. World J Clin Cases 2022; 10:1441-1446. [PMID: 35211581 PMCID: PMC8855176 DOI: 10.12998/wjcc.v10.i4.1441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/28/2021] [Accepted: 12/23/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Relapsing polychondritis (RP) is a rare inflammatory disease involving the systemic cartilage, such as the auricle, trachea, and bronchiole, among others. A patient with RP shows variable symptoms based on the involved cartilage.
CASE SUMMARY A 72-year-old Japanese woman with a history of redness of the bilateral auricles for 3 d was referred to a clinician. The clinician prescribed antibiotics to the patient; however, the symptoms worsened; thus, she was referred to our hospital. Head and neck magnetic resonance imaging (MRI) showed edematous auricle with remarkable contrast, fluid collection in the bilateral mastoid cells, suggesting otitis media. The eustachian tube (ET) on the right side was also edematous with contrast enhancement. The patient was suspected of RP according to the diagnostic criteria. A biopsy of the auricular cartilage was performed by an otorhinolaryngologist, confirming pathological proof of RP. Treatments with steroids were immediately administered thereafter.
CONCLUSION We highlight a rare case of RP with radiologically confirmed involvement of ET in the MRI.
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Affiliation(s)
- Daisuke Yunaiyama
- Department of Radiology, Tokyo Medical University Hospital, Shinjuku-ku 160-0023, Tokyo, Japan
- Department of Radiology, Tokyo Medical University Hachioji Medical Center, Hachioji-shi 193-0998, Japan
| | - Akiko Aoki
- Department of Rheumatology, Tokyo Medical University Hachioji Medical Center, Hachioji-shi 193-0998, Japan
| | - Hiroshi Kobayashi
- Department of Rheumatology, Tokyo Medical University Hachioji Medical Center, Hachioji-shi 193-0998, Japan
| | - Miwako Someya
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, Hachioji-shi 193-0998, Japan
| | - Mitsuru Okubo
- Department of Radiology, Tokyo Medical University Hachioji Medical Center, Hachioji-shi 193-0998, Japan
| | - Kazuhiro Saito
- Department of Radiology, Tokyo Medical University Hospital, Shinjuku-ku 160-0023, Tokyo, Japan
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Aoki A, Kobayashi H, Abe S, Kimura T, Taguchi T, Yuuta H. [A case of methotrexate-associated diffuse large B-cell lymphoma with splenial lesions of the corpus callosum on brain MRI after complete remission with chemotherapy]. Nihon Ronen Igakkai Zasshi 2022; 59:96-101. [PMID: 35264540 DOI: 10.3143/geriatrics.59.96] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
An 86-year-old woman in a wheelchair was accompanied by her husband and son as she visited our outpatient clinic due to disturbed consciousness and fever. Twenty-seven years earlier, she had been diagnosed with rheumatoid arthritis and had been treated with methotrexate (MTX) and low-dose prednisolone (PSL). She stopped taking MTX four years previously when she was diagnosed with diffuse large B cell lymphoma of the paranasal sinus. Her lymphoma went into remission after six cycles of systemic immunochemotherapy. MRI after hospitalization revealed a lesion in the splenium of the corpus callosum that was hyperintense on diffusion-weighted imaging and which had low apparent diffusion coefficient values. An analysis of the cerebrospinal fluid revealed no atypical cells. The MRI findings were atypical, but her consciousness disturbance improved, leading to the diagnosis of mild encephalitis/encephalopathy with a reversible splenial lesion, which would be associated with a transient consciousness disturbance with a good course. However, her consciousness worsened over the next 3 weeks. One month later, a contrast-enhanced MRI showed an enlarged lesion in the callosum as well as new lesions, and the diagnosis of secondary CNS lymphoma was made. Brain biopsy is often not feasible. Less invasive and highly accurate diagnostic methods are needed, such as the identification of a spinal fluid tumor marker.
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Affiliation(s)
- Akiko Aoki
- Rheumatology, Tokyo Medical University Hachioji Medical Center
| | | | - Shine Abe
- Geriatric Medicine, Tokyo Medical University Hachioji Medical Center
| | | | | | - Hidehiro Yuuta
- Radiology, Tokyo Medical University Hachioji Medical Center
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Kobayashi H, Hirai Y, Aoki A. COVID-19 Survivors with Calcineurin Inhibitors-Treated Rheumatoid Arthritis. Mod Rheumatol Case Rep 2021; 6:10-13. [PMID: 34626196 DOI: 10.1093/mrcr/rxab023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/10/2021] [Accepted: 08/10/2021] [Indexed: 12/15/2022]
Abstract
We report two cases recovered from COVID-19 with rheumatoid arthritis which had been in remission or low disease activity by taking calcineurin inhibitor. Both cases had moderate to severe pneumonia treated with intravenous dexamethasone or in the severe case remdesivir in addition to it. These cases suggest that the use of calcineurin inhibitor may have affected the improvement of severe pneumonia.
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Affiliation(s)
- Hiroshi Kobayashi
- Department of Rheumatology, Internal medicine, Tokyo medical university Hachioji medical Center, Hachioji, Tokyo, Japan
| | - Yuji Hirai
- Department of Infectious diseases, Internal medicine, Tokyo medical university, Hachioji medical Center, Hachioji, Tokyo, Japan
| | - Akiko Aoki
- Department of Rheumatology, Internal medicine, Tokyo medical university Hachioji medical Center, Hachioji, Tokyo, Japan
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Ozaki S, Kaji S, Nawa K, Imae T, Aoki A, Nakamoto T, Ohta T, Nozawa Y, Haga A, Nakagawa K. PD-0755 Training modality conversion models with small data and its application to MVCT to kVCT conversion. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07034-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Yamazaki Y, Aoki A, Otaki J. Prevalence and curriculum of sexual and gender minority education in Japanese medical school and future direction. Med Educ Online 2020; 25:1710895. [PMID: 31931679 PMCID: PMC7006669 DOI: 10.1080/10872981.2019.1710895] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 12/04/2019] [Accepted: 12/05/2019] [Indexed: 06/10/2023]
Abstract
Background: In Japan, sexual and gender minorities (SGM) remain stigmatized, provoking hospital access barriers and health disparities from judgmental care. Japan's Western-influenced introduction of SGM course content into medical education for future physicians addresses these disparities, although often perfunctorily and inconsistently.Objective: To examine the prevalence and characteristics of medical education curriculum with respect to SGM patients, we surveyed medical schools.Methods: A medical education faculty member from each of 80 Japanese medical schools received double postcards to identify relevant SGM coursework. Upon acknowledgement, 43 schools received seven-item anonymous questionnaires in March 2018. Survey results were analyzed from the perspective of three of the qualities and abilities required of a physician - Patient Care, Knowledge for Practice, and Professionalism from Japan's Medical Core Curriculum - to develop recommendations for outcomes-based SGM curriculum through the lens of Van Melle's medical education framework.Results: The response rate was 46%, with 22 schools providing SGM lectures mostly to first- and third-year students. Obstetrics and Gynecology, Neuropsychiatry, and Introduction to Medicine lectures were the top three subjects offering SGM lectures, primarily consisting of basic knowledge of SGM and Differences in Sex Development. Several lectures addressed the health challenges of SGM. Primary reasons for not offering SGM lectures were lack of suitable instructors or no school policies.Conclusions: Students can best experience the humanity of SGM patients and employ more appropriate diagnostic practices and modes of treatment with targeted curriculum to address SGM health disparities and inclusion of SGM patients in clinical practice training. To disseminate SGM education in Japanese medical schools, development of qualified instructors and policies is essential, employing currently active experts. The Van Melle reforms framework can guide in the development of recommended tailored learning experiences and lectures for improved and expanded SGM education, integrating appropriate coursework within current medical core curriculum structure.
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Affiliation(s)
- Yuka Yamazaki
- Department of Medical Education, Tokyo Medical University, Tokyo, Japan
| | - Akiko Aoki
- Department of Rheumatology, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Junji Otaki
- Department of Medical Education, Tokyo Medical University, Tokyo, Japan
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Abstract
OBJECTIVES To investigate the response of glucocorticoid (GC) therapy for patients with polymyalgia rheumatica (PMR) and predictive factors which correspond to the long-term GC. METHODS We reviewed 93 patients with PMR who were treated with GC for more than 6 months. We compared the clinical findings between patients who achieved remission within 24 months (early-remission group, n = 40) and those who required GC therapy for more than 24 months (long-therapy group, n = 24). RESULTS Among 93 patients, 49 have achieved a remission, 35 were undergoing treatment, and 9 have transferred to other hospitals or died. Rate of remission of patients treated for one year GC therapy was in 12% and 53% after 2 years. Serum CRP of long-therapy group was significantly higher than those of the early-remission group. The ratio of patients who experienced more than one relapse within 6 months was 37.5% of long-therapy group and 7.5% of early-remission group. Multivariate logistic regression analysis showed that the history of relapse until 6 months was a significant predictor of long therapy. CONCLUSIONS Some patients need the long-term therapy for more than 4 years. The history of relapse till 6 months is a significant predictor of the long-term GC therapy.
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Affiliation(s)
- Akiko Aoki
- Department of Rheumatology, Department of General Medicine & Primary Care, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Hiroshi Kobayashi
- Department of Rheumatology, Department of General Medicine & Primary Care, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Yoshiko Yamaguchi
- Department of Rheumatology, Department of General Medicine & Primary Care, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
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Aoki A, Kobayashi H. THU0293 PREDICTORS OF LONG-TERM THERAPY WITH GLUCOCORTICOID IN POLYMYALGIA RHEUMATICA. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Polymyalgia rheumatica (PMR) is a common inflammatory condition of elderly persons. Clinical symptoms respond to low-dose glucocorticoids (GC), but treatment is often required for several years. 2015 EULAR/ACR recommendations1)recommend considering early introduction of methotrexate (MTX) in addition to GC, particularly in patients at a high risk for relapse and/or prolonged therapy. However, risk factors for prolonged therapy are not clear yet.Objectives:We investigated predictive factors which corresponded to the long-term GC therapy.Methods:This was a retrospective study in a single general hospital in Japan. We reviewed the medical records of the Japanese patients with PMR between April 2011 and January 2020. Diagnosis of PMR was based on Bird’s criteria or 2012 EULAR/ACR Classification Criteria2). All patients were treated with prednisolone (PSL), according to the BSR and BHPR guidelines3), for more than 6 months. Patients treated with MTX and accompanied by the giant cell arteritis were excluded from this study. Relapse was defined as the reappearance of symptoms associated with elevated C-reactive protein (CRP) levels in patients receiving GC that required an increase in GC dose. Remission was defined as the absence of clinical symptoms and normal CRP with discontinuation of GC. We compared the clinical findings, laboratory data at baseline and clinical course between those who achieved remission within 2 years (early-remission group) and those who required GC therapy for more than 2 years (long-therapy group). Comparisons between groups were made using Student’s t-test and chi-square test (IBM SSPE statistics version 26). This study was approved by the ethics committee of Tokyo Medical University (T2019-0079).Results:As of January 2020, 89 patients have been treated with PSL for more than 6 months. 50 patients have achieved a remission, 29 were undergoing treatment, and 10 have transferred to other hospitals or died (Table 1). The median time required for the patients to achieve remission was 16 months (Interquartile Range 12-21). After one-year GC therapy, remission was achieved in 14% (11/77), 66% (41/62) after 2-year, 84% (47/56) after 3-year, and 91.0% (49/54) after 4-years. Forty-one patients, who achieved remission within 2 years, were included in the early-remission group. Twenty-one were included in the long therapy group (Table 1). There were no differences in sex, age at onset, body mass index, clinical features, and serum albumin at diagnosis. Serum CRP of long-therapy group was significantly higher than those of the early-remission group (Table 2). Mean relapse times in the full follow-up times were 0.4 in the early-remission group and 3.1 in the long-therapy group. Multivariate logistic regression analysis showed that history of relapse till 6 months was significant predictors of the long-term GC therapy (odds ratio, 6.48; 95%CI 1.44-29.12).Conclusion:The remission rates of our study are lower than those of the previous reports. We have tapered GC gradually according to the BSR and BHPR guidelines3). However, some patients need the long-term therapy for more than 2 years. We might consider additional MTX therapy in patients who experience a relapse during the first six months.References:[1]Dejaco C, et al. 2015 recommendations for the management of polymyalgia rheumatica: a European League against Rheumatism/American College of Rheumatology collaborative initiative. Ann Rheum Dis 2015; 74:1799-1807.[2]Dasgupta B, et al: 2012 provisional classification criteria for polymyalgia rheumatica: a European League against Rheumatism/American College of Rheumatology collaborative initiative. Ann Rheum Dis 2012;71: 484-492.[3]Dasgupta, B, et al. BSR and BHPR guidelines for the management of polymyalgia rheumatica. Rheumatology 2010; 49:186-190.Disclosure of Interests:None declared
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Watanabe S, Matsumoto N, Koshio J, Ishida A, Tanaka T, Abe T, Ishikawa D, Shoji S, Nozaki K, Ichikawa K, Kondo R, Otsubo A, Aoki A, Kajiwara T, Koyama K, Miura S, Yoshizawa H, Kikuchi T. MA21.05 Phase II Trial of the Combination of Alectinib with Bevacizumab in ALK-Positive Nonsquamous Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.676] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Hiwatari R, Katayama K, Nakamura M, Miyoshi Y, Aoki A, Asakura N, Utoh H, Homma Y, Tokunaga S, Nakajima N, Someya Y, Sakamoto Y, Tobita K. Development of plant concept related to tritium handling in the water-cooling system for JA DEMO. Fusion Engineering and Design 2019. [DOI: 10.1016/j.fusengdes.2019.03.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Watanabe T, Ueda M, Ishiguro S, Hayashi Y, Aoki A, Shinozaki M, Kato K, Akiyama K, Shimoda K. Early Improvement and Marriage Are Determinants of the 12-Month Treatment Outcome of Paroxetine in Outpatients with Panic Disorder. Clin Psychopharmacol Neurosci 2017; 15:382-390. [PMID: 29073750 PMCID: PMC5678480 DOI: 10.9758/cpn.2017.15.4.382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 02/22/2017] [Accepted: 03/18/2017] [Indexed: 01/06/2023]
Abstract
Objective In this study, we investigated the determinants of remission and discontinuation of paroxetine pharmacotherapy in outpatients with panic disorder (PD). Methods Subjects were 79 outpatients diagnosed with PD who took 10-40 mg/day of paroxetine for 12 months. The candidate therapeutic determinants included the serotonin transporter gene-linked polymorphic region and the -1019C/G promoter polymorphism of the serotonin receptor 1A as genetic factors, educational background and marital status as environmental factors, and early improvement (EI) at 2 weeks as a clinical factor were assessed. The Clinical Global Impression scale was used to assess the therapeutic effects of the pharmacotherapy. Results Cox proportional hazards regression was performed to investigate the significant predictive factors of remission and discontinuation. EI was only a significant predictive factor of remission. EI was a significant predictive factor of remission (hazard ratio [HR], 2.709; 95% confidence interval [CI], 1.177-6.235). Otherwise, EI and marital status were significant predictive factors of the discontinuation. EI (HR, 0.266; 95% CI, 0.115-0.617) and being married (HR, 0.437; 95% CI, 0.204-0.939) were considered to reduce the risk of treatment discontinuation. In married subjects, EI was a significant predictive factor of the discontinuation (HR, 0.160; 95% CI, 0.045-0.565). However, in unmarried subjects, EI was not a significantly predictive factor for the discontinuation. Conclusion EI achievement appears to be a determinant of PD remission in paroxetine treatment. In married PD patients, EI achievement also appears to reduce a risk of discontinuation of paroxetine treatment.
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Affiliation(s)
- Takashi Watanabe
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
| | - Mikito Ueda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
| | - Shin Ishiguro
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
| | - Yuki Hayashi
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
| | - Akiko Aoki
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
| | - Masataka Shinozaki
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
| | - Kazuko Kato
- Mental Health Clinic SAKURA-RA, Utsunomiya, Japan
| | - Kazufumi Akiyama
- Department of Biological Psychiatry and Neuroscience, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
| | - Kazutaka Shimoda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
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Saito S, Fujii K, Ozeki Y, Ohmori K, Honda G, Mori H, Kato K, Kuroda J, Aoki A, Asahi H, Sato H, Shimoda K, Akiyama K. Cognitive function, treatment response to lithium, and social functioning in Japanese patients with bipolar disorder. Bipolar Disord 2017; 19:552-562. [PMID: 28691278 DOI: 10.1111/bdi.12521] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 06/07/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Patients with bipolar disorder often suffer from cognitive impairment that significantly influences their functional outcome. However, it remains unknown whether lithium has a central role in cognition and functional outcome. We examined whether cognition and functional outcome were predicted by demographic and clinical variables, including the response to lithium, in lithium-treated patients with bipolar disorder. METHODS We evaluated 96 lithium-treated euthymic patients with bipolar disorder and 196 age- and-gender-matched healthy controls, using the Brief Assessment of Cognition in Schizophrenia (BACS). The patients were also assessed using the Social Functioning Scale (SFS) and "The Retrospective Criteria of Long-Term Treatment Response in Research Subjects with Bipolar Disorder" (Alda) scale, which was evaluated as either a continuous measure of the total scale or a dichotomous criterion. RESULTS Multiple regression analysis revealed two key findings: first, that the premorbid intelligence quotient, age, and number of mood episodes were predictors of the BACS composite score; and, second, that the BACS composite score, negative symptoms, and continuous measure on the total Alda scale (but not its dichotomy) predicted the total SFS score. Structural equation modeling (SEM) was used to confirm these findings, and additionally revealed that the Alda scale was significantly associated with negative symptoms and also the number of mood episodes, regardless of how it was evaluated. CONCLUSIONS SEM delineated how demographic and clinical variables, cognitive performance, and response to lithium treatment were causally associated with, and converged on, social function. The putative role of the Alda scale for social function warrants further study.
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Affiliation(s)
- Satoshi Saito
- Department of Biological Psychiatry and Neuroscience, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan.,Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan
| | - Kumiko Fujii
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan
| | - Yuji Ozeki
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan
| | - Kenichi Ohmori
- Shiseikai, Takizawa Hospital, Utsunomiya, Tochigi, Japan
| | - Gyo Honda
- Seiseido Kohseikai, Mori Hospital, Utsunomiya, Tochigi, Japan
| | - Harunobu Mori
- Seiseido Kohseikai, Mori Hospital, Utsunomiya, Tochigi, Japan
| | - Kazuko Kato
- Sakura La Mental Clinic, Utsunomiya, Tochigi, Japan
| | | | - Akiko Aoki
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan
| | | | | | - Kazutaka Shimoda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan
| | - Kazufumi Akiyama
- Department of Biological Psychiatry and Neuroscience, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan
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Kakizaki S, Aoki A, Tsubokawa M, Lin T, Mizutani K, Koshy G, Sadr A, Oda S, Sumi Y, Izumi Y. Observation and determination of periodontal tissue profile using optical coherence tomography. J Periodontal Res 2017; 53:188-199. [PMID: 29063599 DOI: 10.1111/jre.12506] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVE Diagnosis is a crucial step in periodontal treatment. The aim of this study was to evaluate the effectiveness of optical coherence tomography (OCT) for observation and determination of periodontal tissue profiles in vivo. MATERIAL AND METHODS In experiment 1, refractive indices of purified water, porcine gingiva and human gingiva at 1330 nm were determined for the analysis of OCT images of periodontal tissues. In experiment 2, OCT examination was performed in the midlabial apico-coronal plane of mandibular anteriors in 30 Asian volunteers with healthy gingiva. Sulcus depth was measured on intra-oral photographs taken during probing. In the OCT images, the gingival, epithelial and connective tissue thickness, and the position of alveolar bone crest were determined and finally, the biologic width was measured. RESULTS Refractive indices of purified water, porcine gingiva and human gingiva were 1.335, 1.393 and 1.397, respectively. Cross-sectional images of gingival epithelium, connective tissue and alveolar bone were depicted in real-time. The sulcular and junctional epithelium could be visualized occasionally. Laser penetration and reflection were limited to a certain depth with an approximate maximal imaging depth capability of 1.5 mm and OCT images of the periodontal structure were not clear in some cases. The average maximal thickness of gingiva and epithelium and biologic width at the mandibular anteriors were 1.06 ± 0.21, 0.49 ± 0.15 and 2.09 ± 0.60 mm, respectively. CONCLUSION OCT has promise for non-invasive observation of the periodontal tissue profile in detail and measurement of internal periodontal structures including biologic width in the anterior region.
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Affiliation(s)
- S Kakizaki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - A Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - M Tsubokawa
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - T Lin
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.,School of Dentistry, Chung Shan Medical University, Taichung, Taiwan.,Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - K Mizutani
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - G Koshy
- Department of Periodontics, Sri Sankara Dental College, Varkala, Kerala, India
| | - A Sadr
- Department of Restorative Dentistry, University of Washington School of Dentistry, Seattle, WA, USA
| | - S Oda
- Oral Diagnosis and General Dentistry, University Hospital of Dentistry, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Y Sumi
- Center of Advanced Medicine for Dental and Oral Diseases National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Y Izumi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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Watanabe T, Ishiguro S, Aoki A, Ueda M, Hayashi Y, Akiyama K, Kato K, Shimoda K. Genetic Polymorphism of 1019C/G (rs6295) Promoter of Serotonin 1A Receptor and Catechol-O-Methyltransferase in Panic Disorder. Psychiatry Investig 2017; 14:86-92. [PMID: 28096880 PMCID: PMC5240452 DOI: 10.4306/pi.2017.14.1.86] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 01/28/2016] [Accepted: 01/28/2016] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE Family and twin studies have suggested genetic liability for panic disorder (PD) and therefore we sought to determine the role of noradrenergic and serotonergic candidate genes for susceptibility for PD in a Japanese population. METHODS In this age- and gender-matched case-control study involving 119 PD patients and 119 healthy controls, we examined the genotype distributions and allele frequencies of the serotonin transporter gene linked polymorphic region (5-HTTLPR), -1019C/G (rs6295) promoter polymorphism of the serotonin receptor 1A (5-HT1A), and catechol-O-methyltransferase (COMT) gene polymorphism (rs4680) and their association with PD. RESULTS No significant differences were evident in the allele frequencies or genotype distributions of the COMT (rs4680), 5-HTTLPR polymorphisms or the -1019C/G (rs6295) promoter polymorphism of 5-HT1A between PD patients and controls. Although there were no significant associations of these polymorphisms with in subgroups of PD patients differentiated by gender or in subgroup comorbid with agoraphobia (AP), significant difference was observed in genotype distributions of the -1019C/G (rs6295) promoter polymorphism of 5-HT1A between PD patients without AP and controls (p=0.047). CONCLUSION In this association study, the 1019C/G (rs6295) promoter polymorphism of the 5-HT1A receptor G/G genotype was associated with PD without AP in a Japanese population.
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Affiliation(s)
- Takashi Watanabe
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Tochigi, Japan
| | - Shin Ishiguro
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Tochigi, Japan
| | - Akiko Aoki
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Tochigi, Japan
| | - Mikito Ueda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Tochigi, Japan
| | - Yuki Hayashi
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Tochigi, Japan
| | - Kazufumi Akiyama
- Biological Psychiatry and Neuroscience, Dokkyo Medical University School of Medicine, Shimotsuga, Tochigi, Japan
| | - Kazuko Kato
- Sakura La Mental Clinic, Utsunomiya, Tochigi, Japan
| | - Kazutaka Shimoda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Tochigi, Japan
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Aoki A, Senuma A, Osada A, Nagaoka S. AB0529 Long-Term Glucocorticoid Monotherapy Can Lead To Remission in Japanese Patients with Polymyalgia Rheumatica without Notable Adverse Effects. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Ozeki Y, Sekine M, Fujii K, Watanabe T, Okayasu H, Takano Y, Shinozaki T, Aoki A, Akiyama K, Homma H, Shimoda K. Phosphoserine phosphatase activity is elevated and correlates negatively with plasma d-serine concentration in patients with schizophrenia. Psychiatry Res 2016; 237:344-50. [PMID: 26804975 DOI: 10.1016/j.psychres.2016.01.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Revised: 10/26/2015] [Accepted: 01/05/2016] [Indexed: 01/01/2023]
Abstract
The pathophysiology of schizophrenia may involve N-methyl-D-aspartate receptor (NMDAR) hypofunction. D-3serine and glycine are endogenous l-serine-derived NMDAR co-agonists. We hypothesized that the l-serine synthesis pathway could be involved in schizophrenia. We measured the activity of phosphoserine phosphatase (PSP), a rate-limiting enzyme in l-serine synthesis, in peripheral blood mononuclear cells of 54 patients with schizophrenia and 49 normal control subjects. Plasma amino acid (l-serine, d-serine, glycine, glutamine, and glutamate) levels were measured by high performance liquid chromatography. Peripheral blood mRNA expression levels of PHGDH, PSAT1, PSP, and SR, determined by quantitative real-time PCR were compared between patients and controls. PSP activity was higher in patients than in controls, especially in male patients. In male patients, the plasma l-serine concentration was higher than that in controls. In patients, PSP activity was negatively correlated with plasma d-serine and glycine levels. Furthermore, PSP activity was positively correlated with plasma l-serine concentration. These results were statistically significant only in male patients. PSP, PSAT1, and PHGDH mRNA levels were lower in patients than in controls, except when the PHGDH expression level was compared with ACTB expression. In summary, we found the l-serine synthesis system to be altered in patients with schizophrenia, especially in male patients.
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Affiliation(s)
- Yuji Ozeki
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan; Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan.
| | - Masae Sekine
- Laboratory of Biomolecular Science, Graduate School of Pharmaceutical Sciences, Kitasato University, Tokyo, Japan
| | - Kumiko Fujii
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan
| | - Takashi Watanabe
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan
| | - Hiroaki Okayasu
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan
| | - Yumiko Takano
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan
| | - Takahiro Shinozaki
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan
| | - Akiko Aoki
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan
| | - Kazufumi Akiyama
- Department of Biological Psychiatry and Neuroscience, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan
| | - Hiroshi Homma
- Laboratory of Biomolecular Science, Graduate School of Pharmaceutical Sciences, Kitasato University, Tokyo, Japan
| | - Kazutaka Shimoda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan
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Abstract
BACKGROUND Rheumatoid arthritis (RA) is a complex chronic illness requiring continued medical care. During the past decade, the therapeutic options for RA have increased significantly; these often have a higher risk of adverse effects and are more expensive than traditional drugs. Rheumatologists may hence face difficulties when deciding on the optimal modality in initiating or changing treatment. The aim of this study was to explore the Japanese physicians' usual style of and preferences for decision making regarding RA treatment. METHODS This was a cross-sectional study conducted using an Internet survey. Respondents were asked about their usual style of making treatment decisions (perceived style), and their perception of the importance of physicians' actions and patients' attitudes. RESULTS Of the 485 physicians who were sent the questionnaire, 157 responded completely (response rate: 32.3%). Ninety-two percent of the respondents were men, and 57% were clinicians with more than 20 years of experience. Their specialties were general medicine (29%), rheumatology (27%), orthopedics (31%), and rehabilitation (12%). Sixty-one (39%) stated that they usually presented multiple treatment options to their patients and selected a decision for them, 42 (27%) shared the decision making with their patients, 34 (22%) let their patients choose the treatment, and 20 (13%) made the treatment decision for the patients. Physicians using the shared decision making (SDM) style desired for their patients to have supportive family and friends, to discuss with nurses, and to follow the doctors' directions more strongly compared with physicians using the other styles. There were no significant differences in sex, duration of clinical experience, major place of clinical work, and number of patients per month by the styles. More number of rheumatologists and physicians with specialist qualifications stated that they practiced SDM. CONCLUSION To enhance patient participation, physicians need to recognize the importance of discussing treatment options with patients in addition to giving them information.
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Affiliation(s)
- Akiko Aoki
- Department of Rheumatology, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
- Correspondence: Akiko Aoki, Department of Rheumatology, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji, Tokyo 193-0998, Japan, Tel +81 42 665 5611, Fax +81 42 665 1796, Email
| | - Sadayoshi Ohbu
- Department of Sociology, Rikkyo University, Tokyo, Japan
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Takano Y, Ozeki Y, Sekine M, Fujii K, Watanabe T, Okayasu H, Shinozaki T, Aoki A, Akiyama K, Homma H, Shimoda K. Multi-regression analysis revealed a relationship between l-serine and methionine, a component of one-carbon metabolism, in the normal control but not in the schizophrenia. Ann Gen Psychiatry 2016; 15:23. [PMID: 27588034 PMCID: PMC5007820 DOI: 10.1186/s12991-016-0113-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 08/22/2016] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Alterations in one-carbon metabolism (OCM) have been observed in patients with schizophrenia (SZ), but a comprehensive study of OCM has not yet been conducted. A carbon atom is transferred from l-serine to methionine during OCM, but the relationship between l-serine and methionine in SZ is not yet known. We investigated the relationship between l-serine and methionine to obtain a comprehensive understanding of OCM in SZ. METHODS We recruited forty-five patients with SZ and thirty normal controls (NC). Whole blood, plasma, and DNA specimens were obtained from all participants. Plasma l-serine, d-serine, glycine, methionine, and total homocysteine levels were measured using high-performance liquid chromatography. Plasma vitamin B12 and total folate were measured using a chemiluminescent protein-binding immunoassay. Clinical symptoms were estimated using the positive and negative syndrome scale (PANSS). The methylenetetrahydrofolate reductase (MTHFR) C667T genotype and A298C genotype, which are involved in MTHFR activity, were determined using the TaqMan genotyping assay system. RESULTS Analysis of variance was used to confirm that the SZ cohort has higher plasma homocysteine levels and lower plasma folate levels than the NC group. Multi-regression analysis revealed a relationship between l-serine and methionine in the NC group but not in the SZ group. The MTHFR genotype did not affect the relationship between l-serine and methionine in each group. The total PANSS score was significantly related to d-serine and folate levels and to age. Positive PANSS scores were significantly related to both glycine and sex. In addition, both glycine and d-serine were significantly correlated with negative PANSS scores. CONCLUSIONS We found impairment of the relationship between l-serine and methionine in SZ. Clinical symptoms of SZ were partially correlated with the OCM components. These findings contributed to our understanding of OCM alteration in SZ and may explain why the alteration occurs.
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Affiliation(s)
- Yumiko Takano
- Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi Japan
| | - Yuji Ozeki
- Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi Japan ; Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Masae Sekine
- Laboratory of Biomolecular Science, Graduate School of Pharmaceutical Sciences, Kitasato University, Tokyo, Japan
| | - Kumiko Fujii
- Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi Japan
| | - Takashi Watanabe
- Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi Japan
| | - Hiroaki Okayasu
- Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi Japan
| | - Takahiro Shinozaki
- Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi Japan
| | - Akiko Aoki
- Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi Japan
| | - Kazufumi Akiyama
- Department of Biological Psychiatry and Neuroscience, Dokkyo Medical University School of Medicine, Mibu, Tochigi Japan
| | - Hiroshi Homma
- Laboratory of Biomolecular Science, Graduate School of Pharmaceutical Sciences, Kitasato University, Tokyo, Japan
| | - Kazutaka Shimoda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi Japan
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Hayashi Y, Watanabe T, Aoki A, Ishiguro S, Ueda M, Akiyama K, Kato K, Inoue Y, Tsuchimine S, Yasui-Furukori N, Shimoda K. Factors Affecting Steady-state Plasma Concentrations of Enantiomeric Mirtazapine and its Desmethylated Metabolites in Japanese Psychiatric Patients. Pharmacopsychiatry 2015; 48:279-85. [DOI: 10.1055/s-0035-1565069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Y. Hayashi
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Kitakobayashi, Mibu-machi, Shimotsuga, Tochigi, Japan
| | - T. Watanabe
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Kitakobayashi, Mibu-machi, Shimotsuga, Tochigi, Japan
| | - A. Aoki
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Kitakobayashi, Mibu-machi, Shimotsuga, Tochigi, Japan
| | - S. Ishiguro
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Kitakobayashi, Mibu-machi, Shimotsuga, Tochigi, Japan
| | - M. Ueda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Kitakobayashi, Mibu-machi, Shimotsuga, Tochigi, Japan
| | - K. Akiyama
- Department of Biological Psychiatry and Neuroscience, Dokkyo Medical University School of Medicine, Kitakobayashi, Mibu-machi, Shimotsuga, Tochigi, Japan
| | - K. Kato
- Sakura La Mental Clinic, Youtou, Utsunomiya, Tochigi, Japan
| | - Y. Inoue
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Kitakobayashi, Mibu-machi, Shimotsuga, Tochigi, Japan
| | - S. Tsuchimine
- Department of Neuropsychiatry, Hirosaki University Graduate School of Medicine, Zaifucho, Hirosaki, Aomori, Japan
| | - N. Yasui-Furukori
- Department of Neuropsychiatry, Hirosaki University Graduate School of Medicine, Zaifucho, Hirosaki, Aomori, Japan
| | - K. Shimoda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Kitakobayashi, Mibu-machi, Shimotsuga, Tochigi, Japan
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Aoki A, Takagi K, Nagase H, Nakanishi T. Anti-androgenic effects induce obesity associated with impairment of hepatic gluconeogenesis in mice. Toxicol Lett 2015. [DOI: 10.1016/j.toxlet.2015.08.779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Sugiura M, Aoki A. [An elderly man presenting polyarthritis diagnosed as chronic tophaceous gout]. Nihon Ronen Igakkai Zasshi 2015; 52:415-420. [PMID: 26700782 DOI: 10.3143/geriatrics.52.415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
An 85-year-old man was admitted to our hospital for swollen and painful bilateral lower legs and a high fever. He was initially diagnosed with acute cellulitis and treated with antibiotics. Several days after the improvement of his swollen legs, he complained of both shoulder and arm pain. The laboratory data at this time were as follow: C-reactive protein 10.7 mg/dL, uric acid 8.7 mg/dL, and creatinine 1.07 mg/dL. Both rheumatoid factor and anti-CCP antibody were negative. Whole-body gallium scintigraphy showed a high pathological accumulation in both the shoulders and left wrist. As polymyalgia rheumatica was suspected, oral prednisolone (PSL) of 10 mg/day was started. The patient's shoulder pain improved and he was discharged. However, he was hospitalized twice in the next month because of left shoulder, left knee, right arm, and right wrist pain. During the third hospitalization, we found a subcutaneous nodule on right toe. Aspiration material from the nodule was a white paste, showing acicular crystals under the microscope. According to these findings, the nodule was diagnosed as a tophaceous nodule, and recurrent episodes of polyarthritis were diagnosed as chronic tophaceous gout. Low-dose PSL was continued and febuxostat was added. This patient had multiple risk factors for chronic tophaceous gout: obesity, a habit of drinking, diabetes mellitus, hyperlipidemia, congestive heart failure, and interruption of allopurinol treatment. We herein discuss the clinical course of the patient, the interruption of allopurinol treatment and polypharmacy in elderly patients.
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Affiliation(s)
- Misa Sugiura
- Department of General Medicine, Tokyo Medical University Hachioji Medical Center
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Aoki A, Oka H, Nakamura M, Aoki I. AB0564 Starting Dose of Prednisolone for Japanese Patients with Polymyalgia Rheumatica. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Aoki A, Ashizawa T, Ebata A, Nasu Y, Fujii T. Group A Streptococcus pharyngitis outbreak among university students in a judo club. J Infect Chemother 2014; 20:190-3. [DOI: 10.1016/j.jiac.2013.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Revised: 10/07/2013] [Accepted: 10/08/2013] [Indexed: 11/26/2022]
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Omoto T, Aoki A, Maruta K, Sakurai S, Iizuka H, Kawaura H. Severity score for mitral valve repair in active stage infective endocarditis. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1367403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Aoki A, Ono S, Ueda A, Hagiwara E, Tsuji T, Misumi M, Ideguchi H, Takeda Y, Ishigatsubo Y. Myositis in primary Sjögren's syndrome: clinical and pathological report. Mod Rheumatol 2014; 13:57-61. [PMID: 24387117 DOI: 10.3109/s101650300008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract To clarify the clinical features of myositis complicated with primary Sjögren's syndrome (SS), we studied 89 patients with Sjögren's syndrome (one male and 88 females; mean age 56.0 ± 15.31 years). Myositis was diagnosed from clinical findings, muscle enzymes, electromyographic findings, and muscle biopsy findings. Myositis was diagnosed in 5 of 89 SS patients (5.6%). One patient developed myositis 7 months after the onset of SS. The other four patients were diagnosed with myositis and SS simultaneously. Muscular weakness was mild and slowly progressive over 4-14 months (mean 8.4 months). All patients were able to walk without any assistance at the start of prednisolone therapy. Muscular enzymes were slightly elevated (from 1.5- to 12-fold). All patients tested negative for anti-Jo1 antibody and tested positive for antinuclear antibody. Anti-Ro(SSA) antibody was positive in 4/5 (90%); anti-La(SSB) was positive in 2/5 (40%). Although the clinical features of all patients met the criteria for polymyositis of Bohan, they responded well to small or moderate doses of prednisolone, which could be decreased without a recurrence of muscular weakness in all patients. Myositis with Sjögren's syndrome showed relatively moderate symptoms and responded well to prednisolone. A prospective follow-up of patients may provide further information.
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Affiliation(s)
- A Aoki
- Internal Medicine, Yokohama City University, School of Medicine , 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004 , Japan
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Aoki A, Suda A, Nagaoka S, Takeno M, Ishigatsubo Y, Ashizawa T, Ohde S, Takahashi O, Ohbu S. Preferences of Japanese rheumatoid arthritis patients in treatment decision-making. Mod Rheumatol 2014. [DOI: 10.3109/s10165-012-0761-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Aoki A, Ishiguro S, Watanabe T, Ueda M, Hayashi Y, Akiyama K, Kato K, Inoue Y, Tsuchimine S, Yasui-Furukori N, Shimoda K. Factors affecting discontinuation of initial treatment with paroxetine in panic disorder and major depressive disorder. Neuropsychiatr Dis Treat 2014; 10:1793-8. [PMID: 25258536 PMCID: PMC4174019 DOI: 10.2147/ndt.s68670] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE The aims of the present study were to analyze the association between discontinuation of paroxetine (PAX) and the genetic variants of the polymorphism in the serotonin transporter gene-linked polymorphic region (5-HTTLPR) in Japanese patients with panic disorder (PD) and major depressive disorder (MDD). METHODS The 5-HTTLPR genotype was determined by polymerase chain reaction method. PAX plasma concentration was measured by high-performance liquid chromatography to confirm adherence. RESULTS When comparing between the PD and MDD patients with the chi-square test and Fisher's exact test, the PD patients had a significant and higher discontinuation rate due to non-adherence than did the MDD patients (13.5% [7/52] versus 0% [0/88], respectively; P<0.001). MDD patients had a significant and higher discontinuation rate due to untraceability than PD patients (12.5% [11/88] versus 1.9% [1/52]; P=0.032). Multilogistic regression revealed a tendency for the long/short and short/short genotypes to affect discontinuation due to adverse effects in PD patients (25.0% versus 6.3%, respectively; P=0.054). CONCLUSION The results indicate that the 5-HTTLPR genotype might contribute to the discontinuation of initial PAX treatment due to adverse effects in PD patients.
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Affiliation(s)
- Akiko Aoki
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Shin Ishiguro
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Takashi Watanabe
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Mikito Ueda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Yuki Hayashi
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Kazufumi Akiyama
- Department of Biological Psychiatry and Neuroscience, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | | | - Yoshimasa Inoue
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Shoko Tsuchimine
- Department of Neuropsychiatry, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Norio Yasui-Furukori
- Department of Neuropsychiatry, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Kazutaka Shimoda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan
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Affiliation(s)
- Yujin Kudo
- Department of Thoracic Surgery, Hachioji Medical Center, Tokyo Medical University
- Division of Thoracic Surgery, Department of Surgery, Tokyo Medical University
| | - Hiroyuki Miura
- Department of Thoracic Surgery, Hachioji Medical Center, Tokyo Medical University
| | - Eiji Nakajima
- Department of Thoracic Surgery, Hachioji Medical Center, Tokyo Medical University
| | - Hidenobu Takahashi
- Department of Thoracic Surgery, Hachioji Medical Center, Tokyo Medical University
| | - Akiko Aoki
- Department of General Medicine, Hachioji Medical Center, Tokyo Medical University
| | - Norihiko Ikeda
- Division of Thoracic Surgery, Department of Surgery, Tokyo Medical University
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Elewa U, Fernandez B, Egido J, Ortiz A, Kaifu K, Tahara N, Ueda S, Yamagishi SI, Takeuchi M, Okuda S, Buraczynska M, Zukowski P, Wacinski P, Ksiazek A, Wu HY, Peng YS, Hung KY, Wu KD, Tu YK, Chien KL, Papale M, Vocino G, Di Paolo S, Pontrelli P, Conserva F, Rocchetti MT, Grandaliano G, De Cosmo S, Gesualdo L, Prkacin I, Duvnjak L, Bulum T, Prkacin I, Duvnjak L, Bulum T, Dumann K, Horrmann B, Lammert A, Gorski M, Kramer B, Heid I, Boger C, Aggarwal HK, Jain D, Talapatra P, Lenghel AR, Moldovan D, Rusu CC, Rusu A, Rahaian R, Bondor CI, Kacso IM, Unal A, Kocyigit I, Yilmaz S, Eser B, Elmali F, Sipahioglu M, Tokgoz B, Oymak O, Velioglu A, Guler D, Arikan H, Koc M, Tuglular S, Ozener C, Pallayova M, Rayner HC, Taheri S, Dasgupta I, Fernandes FB, Fernandes AB, Febba ACDS, Vitalle MSDS, Jung F, Casarini DE, Liu F, Huang M, Fu P, Bulatovic A, Popovic J, Ille K, Jelic S, Beljic Zivkovic T, Dimkovic N, Kohli HS, Ramachandran R, Kumar S, Jha V, Sakhuja V, Hamamoto K, Inaba M, Yamada S, Yoda K, Imanishi Y, Emoto M, Okuno S, Shoji S, Silva A, Fragoso A, Pinho A, Silva C, Santos N, Faisca M, Neves PL, Capolongo G, Restivo A, Pluvio M, Capasso G, Bello BT, Mabayoje OM, Amira OC, Theodoridis M, Panagoutsos S, Roumeliotis A, Kantartzi K, Tsigalou C, Passadakis P, Vargemezis V, Deeb A, Zaoui P, Le Penven S, Tartry D, Ducher M, Fauvel JP, Angioi A, Asunis AM, Cao R, Atzeni A, Conti M, Floris M, Melis P, Pili G, Piras D, Piredda G, Pani A, Murata M, Ishikawa SE, Aoki A, Unal A, Kocyigit I, Cerci I, Dogan E, Arikan T, Sipahioglu M, Tokgoz B, Oymak O, Madziarska K, Letachowicz K, Golebiowski T, Zmonarski SC, Krajewska M, Letachowicz W, Penar J, Kusztal M, Augustyniak-Bartosik H, Klak R, Weyde W, Klinger M. Diabetes - clinical studies. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Chui C, Aoki A, Takeuchi Y, Sasaki Y, Hiratsuka K, Abiko Y, Izumi Y. Antimicrobial effect of photodynamic therapy using high-power blue light-emitting diode and red-dye agent on Porphyromonas gingivalis. J Periodontal Res 2013; 48:696-705. [PMID: 23441868 DOI: 10.1111/jre.12055] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2013] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND OBJECTIVE Antimicrobial photodynamic therapy (a-PDT) using a combination of red-colored laser/light-emitting diode (LED) and blue dye has been employed for periodontal therapy and the antimicrobial effect seems promising. Blue light, which has favorable wavelength properties, would be more effective as a light source for a-PDT because blue light itself possesses an antimicrobial effect. This study aimed to investigate the effect of a-PDT using a novel combination of high-power blue LED and red-dye agent on Porphyromonas gingivalis in vitro. MATERIAL AND METHODS Porphyromonas gingivalis ATCC 33277 suspension was irradiated with blue LED (BL) (425-470 nm) or red LED (RL) (625-635 nm) at 30-90 J/cm(2) , or was mixed with erythrosine (ER), phloxine B (PB) or rose bengal (RB) with or without BL irradiation (30 J/cm(2) ). RL (30 J/cm(2) ) in combination with toluidine blue was employed as positive control. All the suspensions of P. gingivalis were serially diluted, plated and incubated anaerobically, and the numbers of colony-forming units (CFUs) were counted on day 7. RESULTS BL irradiation at 60 and 90 J/cm(2) demonstrated a significant reduction in the numbers of CFUs. ER, PB and RB solutions at 160 μg/mL showed almost no or only a minimal reduction in the numbers of CFUs. BL at 30 J/cm(2) combined with ER, PB or RB at 160 μg/mL resulted in a log reduction of 0.9, 1.0 and 7.1, respectively, in the numbers of CFUs; 30 J/cm(2) BL with RB at 1.6, 16 and 160 μg/mL demonstrated a log reduction of 6.3, 8.0 and 5.5, respectively; and a log reduction of 5.2 was obtained after 30 J/cm(2) RL with 16 μg/mL TB. CONCLUSION Within the limits of this study, BL was found to have an antimicrobial/growth-inhibiting effect on P. gingivalis, and a-PDT using a combination of BL and RB shows promise as a new technical modality for bacterial elimination in periodontal therapy.
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Affiliation(s)
- C Chui
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan; Global Center of Excellence (GCOE) Program, International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University, Tokyo, Japan
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Rosa DSA, Aranha ACC, Eduardo CP, Aoki A. Esthetic Treatment of Gingival Melanin Hyperpigmentation with Er:YAG laser. Forty-eight months of patient follow-up. Med Oral Patol Oral Cir Bucal 2012. [DOI: 10.4317/medoral.17643570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Aoki A, Nagate M, Utsumi K, Tanaka A, Inoue Y, Otaki J, Shimbo T, Ashizawa T. Can we determine depressive conditions on the basis of somatic symptoms? A cross-sectional study of depressive conditions among Japanese patients at a university hospital general medicine clinic. Intern Med 2012; 51:1335-40. [PMID: 22687838 DOI: 10.2169/internalmedicine.51.7328] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE We evaluated the relationship between somatic symptoms and depressive conditions among patients visiting the general medicine clinic of a university hospital. METHODS We distributed interview forms to 332 consecutive patients who visited our clinic for the first time between March and July 2011. Somatic symptoms were rated using a symptom checklist, and depressive conditions were evaluated using the Zung Self-Rating Depression Scale (SDS). We categorized and compared 2 groups of patients: patients with an SDS score of more than 48 (depressive group) and patients with an SDS score of less than 48 (non-depressive group). RESULTS A total of 284 (85.5%) patients returned the forms. The SDS scores were obtained from the forms of 182 patients (64.1%). The average age of these 182 patients was 46.5±18.04 years. The mean number of checked symptoms was 4.3±3.03, and the most common symptom was general fatigue (n=106; 58.2%). The number of checked symptoms in the survey was higher in the depressive group patients than in the non-depressive group patients. Multiple logistic regression analysis indicated that general fatigue, headache, and sleeping problems were significant dependent variables which were related to depressive conditions. We defined these 3 symptoms as depression-related somatic symptoms (DRSS). On a receiver-operating characteristic curve, the optimal cutoff scores were 2 of 3 DRSS and 4 of 20 somatic symptoms. CONCLUSION General physicians should consider possible depressive conditions when patients have 2 or more DRSS or 4 or more somatic symptoms.
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Affiliation(s)
- Akiko Aoki
- Department of General Medicine, Tokyo Medical University Hachioji Medical Center, Japan.
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Pavlic V, Aoki A, Vujic-Aleksic V, Izumi Y. Low-level laser therapy in bone repair: a literature review. Med Oral Patol Oral Cir Bucal 2012. [DOI: 10.4317/medoral.17643542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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42
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Sawabe M, Aoki A, Komaki M, Iwasaki K, Ogita M, Izumi Y. Gingival healing following Er:YAG laser ablation Vs electrosurgery in rats. Med Oral Patol Oral Cir Bucal 2012. [DOI: 10.4317/medoral.17643734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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43
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Matsumoto-Takasaki A, Hanashima S, Aoki A, Yuasa N, Ogawa H, Sato R, Kawakami H, Mizuno M, Nakada H, Yamaguchi Y, Fujita-Yamaguchi Y. Surface plasmon resonance and NMR analyses of anti Tn-antigen MLS128 monoclonal antibody binding to two or three consecutive Tn-antigen clusters. J Biochem 2011; 151:273-82. [DOI: 10.1093/jb/mvr138] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
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Nakanishi T, Yoshioka H, Hiromori Y, Aoki A, Kimura T, Nagase H. Possible mechanism of 2,3,7,8-tetrachlorodibenzo-p-dioxin-induced antiproliferative response in human breast cancer MCF-7 cells through an independent pathway of aryl hydrocarbon receptor. Toxicol Lett 2011. [DOI: 10.1016/j.toxlet.2011.05.588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Tsugawa Y, Ohbu S, Cruess R, Cruess S, Okubo T, Takahashi O, Tokuda Y, Heist BS, Bito S, Itoh T, Aoki A, Chiba T, Fukui T. Introducing the Professionalism Mini-Evaluation Exercise (P-MEX) in Japan: results from a multicenter, cross-sectional study. Acad Med 2011; 86:1026-1031. [PMID: 21694563 DOI: 10.1097/acm.0b013e3182222ba0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
PURPOSE Despite the growing importance of and interest in medical professionalism, there is no standardized tool for its measurement. The authors sought to verify the validity, reliability, and generalizability of the Professionalism Mini-Evaluation Exercise (P-MEX), a previously developed and tested tool, in the context of Japanese hospitals. METHOD A multicenter, cross-sectional evaluation study was performed to investigate the validity, reliability, and generalizability of the P-MEX in seven Japanese hospitals. In 2009-2010, 378 evaluators (attending physicians, nurses, peers, and junior residents) completed 360-degree assessments of 165 residents and fellows using the P-MEX. The content validity and criterion-related validity were examined, and the construct validity of the P-MEX was investigated by performing confirmatory factor analysis through a structural equation model. The reliability was tested using generalizability analysis. RESULTS The contents of the P-MEX achieved good acceptance in a preliminary working group, and the poststudy survey revealed that 302 (79.9%) evaluators rated the P-MEX items as appropriate, indicating good content validity. The correlation coefficient between P-MEX scores and external criteria was 0.78 (P < .001), demonstrating good criterion-related validity. Confirmatory factor analysis verified high path coefficient (0.60-0.99) and adequate goodness of fit of the model. The generalizability analysis yielded a high dependability coefficient, suggesting good reliability, except when evaluators were peers or junior residents. CONCLUSIONS Findings show evidence of adequate validity, reliability, and generalizability of the P-MEX in Japanese hospital settings. The P-MEX is the only evaluation tool for medical professionalism verified in both a Western and East Asian cultural context.
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Affiliation(s)
- Yusuke Tsugawa
- Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
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Aoki A, Ogawa T, Sumino H, Kumakura H, Takayama Y, Ichikawa S, Nitta K. Long-term effects of telmisartan on blood pressure, the renin-angiotensin-aldosterone system, and lipids in hypertensive patients. Heart Vessels 2010; 25:195-202. [PMID: 20512446 DOI: 10.1007/s00380-009-1186-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2009] [Accepted: 07/14/2009] [Indexed: 01/13/2023]
Abstract
We prospectively evaluated long-term (12 months) effects of telmisartan on blood pressure (BP), circulating renin-angiotensin-aldosterone levels, and lipids in hypertensive patients. There were 13 men and 11 women, 59 +/- 8.7 years of age (mean +/- SEM), with untreated essential hypertension. The 20-60 mg doses of telmisartan were administered once daily in the morning until BP130/85 was obtained. Blood pressure and plasma renin activity, plasma angiotensin (Ang) I and Ang II, serum angiotensin-converting enzyme (ACE) activity, plasma aldosterone concentration, plasma human atrial natriuretic peptide (hANP) concentration, and serum lipids were obtained 6 and 12 months after starting telmisartan administration. Systolic and diastolic BP were significantly (P < 0.001, P < 0.001) decreased from 162 +/- 3.3 and 97.7 +/- 2.1 mmHg to 128 +/- 3.8 and 79.6 +/- 2.0 mmHg after 12 months of treatment, respectively. Plasma Ang I and Ang II were unchanged at 12 months. Plasma renin activity and serum ACE activity were significantly (P < 0.001, P < 0.05) increased and plasma aldosterone concentration was unchanged during the study period. Total cholesterol levels were unchanged, but serum triglycerides levels were significantly decreased at 12 months (P < 0.01). Plasma hANP showed no significant alteration throughout the 12-month period. In hypertensive patients, telmisartan is a beneficial antihypertensive drug that also lowers serum triglycerides.
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Affiliation(s)
- Akiko Aoki
- Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
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Aoki A, Kojima F, Uchida K, Tanaka Y, Nitta K. Associations between vascular calcification, arterial stiffness and bone mineral density in chronic hemodialysis patients. Geriatr Gerontol Int 2010; 9:246-52. [PMID: 19702934 DOI: 10.1111/j.1447-0594.2009.00528.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
AIM The aim of our study was to examine the associations between vascular calcification, arterial stiffness and bone mineral density (BMD) in chronic hemodialysis (HD) patients. METHODS The study subjects were 83 (70 men and 13 women) HD patients. All patients had computed tomography (CT) to determine aortic calcification index (ACI), pulse wave velocity (PWV) using a volume-plethysmographic apparatus, and BMD estimated by digital image processing (DIP). RESULTS Patients, 84.3% male, 38.6% diabetic, had a mean age of 59.3 +/- 11.2 years. In univariate linear regression analysis, ACI correlated positively with age (r = 0.586, P < 0.0001), dialysis vintage (r = 0.47, P = 0.002), pulse pressure (r = 0.311, P = 0.004), C-reactive protein (CRP) (r = 0.226, P = 0.0397) and PWV (r = 0.422, P < 0.0001). There was no significant association between ACI and serum markers of mineral metabolism. There was also a positive association between PWV and systolic blood pressure (P = 0.0004) or pulse pressure (P < 0.0001), and a trend towards greater PWV with increasing age (r = 0.494). In multivariate regression analysis only increasing age, pulse pressure, serum levels of albumin and CRP were significantly associated with ACI and PWV. Mean BMD on DIP was 2.7 +/- 0.4 mmAL. ACI was inversely correlated with BMD (r = -0.234, P = 0.0331). CONCLUSIONS Vascular calcification is closely associated with arterial stiffness in HD patients. BMD is inversely correlated with ACI, suggesting that measurement of hand BMD by DIP is a useful tool for assessment of renal bone disease in these patients.
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Affiliation(s)
- Akiko Aoki
- Department of Medicine, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan
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Asamiya Y, Moriyama T, Takano M, Iwasaki C, Kimura K, Ando Y, Aoki A, Kikuchi K, Takei T, Uchida K, Nitta K. Successful treatment with rituximab in a patient with TTP secondary to severe ANCA-associated vasculitis. Intern Med 2010; 49:1587-91. [PMID: 20686295 DOI: 10.2169/internalmedicine.49.3135] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We report a case of thrombotic thrombocytopenic purpura (TTP) secondary to antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis treated by rituximab. TTP secondary to ANCA-associated vasculitis is very rare and has a high mortality rate. We employed rituximab and successfully treated TTP secondary to ANCA-associated vasculitis, because standard therapies, such as steroid therapy, intravenous pulse cyclophosphamide, and repeated plasma exchange (PE), did not suppress her disease activity. This is the first report to suggest that rituximab can achieve complete remission of TTP secondary to ANCA-associated vasculitis.
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Affiliation(s)
- Yukari Asamiya
- Department of Medicine, Kidney Center, Tokyo Women's Medical University
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Tsuruta Y, Takei T, Takano M, Sawara Y, Aoki A, Eguchi A, Kojima C, Moriyama T, Itabashi M, Sugiura H, Tsukada M, Ogawa T, Yoshida T, Uchida K, Tsuchiya K, Nitta K. [Clinico-pathological features and outcome in adult patients with Henoch-Schönlein purpura nephritis]. Nihon Jinzo Gakkai Shi 2010; 52:51-57. [PMID: 20166542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We examined the data of 24 patients with Henoch-Schönlein purpura nephritis (HSPN) over a 5-year follow-up period. Proteinuria, sediment RBC and CRP significantly decreased between the time of diagnosis and the end of the 5-year period. In the steroid usage group (n = 16), proteinuria was significantly higher, and crescent formation was significant higher at the time of diagnosis than in the non-steroid usage group (n = 8). However, there was no significant difference in the decrease in eGFR from the baseline at the end of the 5-year period between the two groups. Furthermore, to clarify the factors influencing the risk of renal function deterioration, we divided the patients into two groups, the (delta eGFR/pre eGFR) <0.25 group (n = 13) and (delta eGFR/pre eGFR) >0.25 group (n = 11), and compared the clinico-pathophysiological characteristics between the two groups. In the (delta eGFR/pre eGFR) >0.25 group, the ratio of glomerular obsolescence at the time of diagnosis was significantly higher than in the (delta eGFR/pre eGFR) <0.25 group. Glomerular obsolescence was identified as an independent risk factor for renal function deterioration. In this study, the prognosis of HSPN was related to glomerular obsolescence rather than to the disease activity. It may be necessary to consider the decrease in nephrons, in accordance with non-immunological glomerular obsolescence, in addition to immunological treatment to clarify the prognosis.
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Affiliation(s)
- Yuki Tsuruta
- Department of Medicine, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan
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Affiliation(s)
- E. Iguchi
- a Materials Science, Department of Mechanical Engineering and Materials Science, Faculty of Engineering , Yokohama National University , Tokiwadai, Hodogaya-Ku, Yokohama , 240-8501 , Japan
| | - N. Nakamura
- a Materials Science, Department of Mechanical Engineering and Materials Science, Faculty of Engineering , Yokohama National University , Tokiwadai, Hodogaya-Ku, Yokohama , 240-8501 , Japan
| | - A. Aoki
- a Materials Science, Department of Mechanical Engineering and Materials Science, Faculty of Engineering , Yokohama National University , Tokiwadai, Hodogaya-Ku, Yokohama , 240-8501 , Japan
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